Helpful Resources

Applicant Data Form

Thank you for applying for a faculty position at Towson University. We would appreciate
you completing and submitting the following information. Please complete all sections.
All data collected are for internal, state, and/or federal reporting and will not be used to for other purposes.

Please tell us your name.

Last Name:

First Name:

Middle Name:

Please tell us the position number, position title, and academic department to which
you applied.

Position number:

Title of Position:

Academic Department:

Please tell us how you learned of this vacancy.

Specify: (Required)A value is required.Minimum number of characters not met.Exceeded maximum number of characters.

A person of Cuban, Mexican, Puerto Rican, South or Central American, or other Spanish
culture or origin regardless of race.

White (Not Hispanic or Latino)

A person having origins in any of the original peoples of Europe, the Middle East,
or North Africa.

Black or African-American (Not Hispanic or Latino)

A person having origins in any of the black racial groups of Africa.

Asian (Not Hispanic or Latino)

A person with origins in any of the original peoples of the Far East, Southeast Asia,
or the Indian subcontinent including, for example, Cambodia, China, India, Japan,
Korea, Malaysia, Pakistan, the Philippine Islands, Thailand, and Vietnam.

Native Hawaiian or Other Pacific Islander (Not Hispanic or Latino)

A person having origins in any of the peoples of Hawaii, Guam, Samoa, or other Pacific
Islands.

American Indian or Alaskan Native (Not Hispanic or Latino)

A person having origins in any of the original peoples of North and South America
(including Central America), and who maintain tribal affiliation or community attachment.

Two or More Races (Not Hispanic or Latino)

All persons who identify with more than one of the above five races.

Voluntary Self-Identification of Disability:

Form CC-305 OMB Control Number 1250-0005

Why are you being asked to complete this form? Because we do business with the government, we must reach out to, hire, and provide
equal opportunity to qualified people with disabilities. To help us measure how well
we are doing, we are asking you to tell us if you have a disability or if you ever
had a disability. Completing this form is voluntary, but we hope that you will choose
to fill it out. If you are applying for a job, any answer you give will be kept private
and will not be used against you in any way.

If you already work for us, your answer will not be used against you in any way.
Because a person may become disabled at any time, we are required to ask all of our
employees to update their information every five years. You may voluntarily self-identify
as having a disability on this form without fear of any punishment because you did
not identify as having a disability earlier.

How do I know if I have a disability? You are considered to have a disability if you have a physical or mental impairment
or medical condition that substantially limits a major life activity, or if you have
a history or record of such an impairment or medical condition.

Blindness

Autism

Bipolar disorder

Deafness

Cerebral palsy

Post-traumatic stress disorder (PTSD)

Cancer

HIV/AIDS

Multiple sclerosis (MS)

Diabetes

Epilepsy

Major depression

Schizophrenia

Muscular dystrophy

Obsessive compulsive disorder

Missing limbs or partially missing limbs

Impairments requiring the use of a wheelchair

Intellectual disability (previously called mental retardation)

Reasonable Accommodation Notice Federal law requires employers to provide reasonable accommodation to qualified individuals
with disabilities. Please tell us if you require a reasonable accommodation to apply
for a job or to perform your job. Examples of reasonable accommodation include making
a change to the application process or work procedures, providing documents in an
alternate format, using a sign language interpreter, or using specialized equipment. ______________________________________________ Section 503 of the Rehabilitation Act of 1973, as amended. For more information about
this form or the equal employment obligations of Federal contractors, visit the U.S.
Department of Labor's Office of Federal Contract Compliance Programs (OFCCP) website
at www.dol.gov/ofccp PUBLIC BURDEN STATEMENT: According to the Paperwork Reduction Act of 1995 no persons
are required to respond to a collection of information unless such collection displays
a valid OMB control number. This survey should take about 5 minutes to complete.

Voluntary Self-Identification of Veteran Status:

Towson University is a government contractor subject to the Vietnam Era Veterans'
Readjustment Assistance Act of 1974 (VEVRAA), as amended by the Jobs for Veterans
Act of 2002, 38 U.S.C. 4212 (VERAA), which requires government contractors to take
affirmative action to employ and advance in employment:

disabled veterans

recently separated veterans

active duty wartime or campaign badge veterans

Armed Forces service medal veterans

These classifications are defined as follows:

A "disabled veteran" is one of the following:

A veteran of the U.S. military, ground, naval or air service who is entitled to compensation
(or who but for the receipt of military retired pay would be entitled to compensation)
under laws administered by the Secretary of Veterans Affairs; or

a person who was discharged or released from active duty because of a service-related
disability.

A "recently separated veteran" is any veteran during the three-year period beginning
on the date of such veteran's discharge or release from active duty in the U.S. military,
ground, naval, or air service.

An "active duty wartime or campaign badge veteran" is a veteran who served on active
duty in the U. S. military, ground, naval or air service during a war, or in a campaign
or expedition for which a campaign badge has been authorized under the laws administered
by the Department of Defense.

An "Armed forces service medal veteran" is a veteran who, while serving on active
duty in the U.S. military, ground, naval or air service participated in a United States
military operation for which an Armed Forces service medal was awarded pursuant to
Executive Order 12985.

Protected veterans may have additional rights under USERRA - the Uniformed Services
Employment and Reemployment Rights Act. In particular, if you were absent from employment
in order to perform service in the uniformed service, you may be entitled to be re-employed
by your employer in the position you would have obtained with reasonable certainty
if not for the absence due to service. For more information, call the U.S. Department
of Labor's Veterans Employment and Training Service (VETS), toll-free at 1-866-4-USA-DOL.

If you believe you belong to any of the categories of protected veterans listed above,
please indicate by checking the appropriate box below. As a government contractor
subject to VEVRAA, we request this information in order to measure the effectiveness
of the outreach and positive recruitment efforts we undertake pursuant to VEVRAA.
Submission of this information is voluntary and refusal to provide it will not subject
you to any adverse treatment. The information provided will be used only in ways that
are consistent with the Vietnam Era Veterans' Readjustment Assistance Act of 1974,
as amended.

Please tell us your month and year of birth.Month:

Year:

Towson University is an equal opportunity/affirmative action employer and has a strong
institutional commitment to diversity. Women, minorities, persons with disabilities
and veterans are encouraged to apply.